By Robin C. Harris
Billy wants to go to a sleepover at Tommy’s house, because Jack and Jerry are going — his two best buds in all the world. But he can’t. He wants to go to summer camp. But he can’t.
He wets the bed — always has. He’s 10 years old, and none of his friends know about it, and he wants desperately to keep it that way. And he’s really, really tired of being told he’ll grow out of it.
Billy’s folks have waited far longer than necessary to intervene. Waiting it out is a non-solution, and the most damaging to the child’s self-esteem. So let’s back up to age 5 or 6, because numerous strategies could have been implemented in the meantime.
Before you do anything else, two things need to happen. First, it’s necessary to assess with the child how important it is to him to stop wetting. While he may be desperate at age 10, he may be less so at 5. And his own commitment to a strategy is crucial to its success. Once you’ve secured his willingness to cooperate — that is, to participate in the strategy — step two is a visit to the pediatrician, because it’s essential to rule out any psychological or medical problems which may exist. This is also a good time to let the doctor know whether Billy is a deep sleeper — one of the factors making bed wetting harder to treat.
Once you have determined that Billy has an underdeveloped bladder, and he is not wetting solely to drive you insane, you are ready to embark on a solution. Chief among these, in all likelihood, is night waking. Once parents have determined what time of night the wetting is taking place, they can formulate a schedule, waking him to use the bathroom a little in advance of those times. We know that most bed wetting takes place during the first three hours if sleep, with a possible additional urge to go around 2 or 3 a.m. in the morning. Until you can pinpoint these times more precisely, it will be hit or miss for while, but you’ll soon find the optimum times to wake him.
Some parents have tried the reward system, effective when kids are young. A cache of little toys is put aside, from which parents draw a trinket to present on a dry morning. This doesn’t necessarily stop bed wetting, but it motivates the child to cooperative in the solution.
The age-old practice of restricting liquid intake for a couple of hours prior to bedtime is still with us; however, many parents cave in to their child’s pathetic request for “just a little drink?” and the system often falls apart. Also, some children view this restriction as punishment, and the child must never be made to feel that he is in any way to blame.
Two forms of medication are often prescribed. DDAVP (Desmopressin) in tablet form (not the nasal spray, because of its side effects) has been on the market more than 20 years. It controls urine production and has been found effective on a temporary basis, such as a social need, like the sleepover Billy so dearly wanted. It needs be started somewhat ahead of time in order for the pediatrician to find the proper dose, The other medication is Imipramine. These options must be discussed with the pediatrician who may or may not agree to prescribe them.
Still more tools in your arsenal are pull-ups. These care most effective with younger children. Some brands tend to be bulky and can often be detected by other kids on an overnight or at summer camp, so older ones shy away from their use.
Bladder training through urine retention is a practice used successfully by some parents. Using a timer or clock, ask the child to tell you when he has to go. Then ask him to hold it for five minutes, gradually increasing the time until a half-hour or 45 minutes is reached.
Finally, there are bed alarms, all of which have a moisture detector which sounds an alarm, The alarm can also be heard by parents who can come in and assist, speeding up the process of getting Billy to the bathroom. One version has an optional vibrator setting rather than an alarm, which is better in social situations, placing all the responsibility on the child.
Rubberized sheets in all their permutations, are part of your arsenal in all situations.
The good news, of course, is that virtually all kids outgrow enuresis by age 12 or 13. But why wait when there are so many strategies at hand?
Robin C. Harris, an 18-year resident of Lake County, is the author of “Journeys out of Darkness, Adventures in Foster Care.” A retired educator, he is a substitute teacher for Lake County schools and has recently completed two works of fiction for children and teens. He is available for tutoring in first through eighth grades. Harris can be contacted at harris.tke@att.net.
